This continuation application demonstrates the presence of all the requirements for our Center to remain a key Network member. We have been a productive member of all Network functions including study design, patient recruitment, manuscript preparation, committee membership and leadership. We have demonstrated the ability to collaborate in a collegial manner with other Network centers. We have also been productive beyond the confines of the Network in terms of collaborative studies, bench and clinical research as well as publications. There are 15 Board certified academic neonatologists who ensure protected time for Network activities. Each year we admit more than 1000 babies to the NICU, including approximately 200 with birth weights < 1.5 kg. The adjacent obstetric service delivers almost 5000 babies each year, many high risk, and is supported by four maternal-fetal specialists with interest in clinical research and commitment to the Network concept. Our subspeciality designated (former level III) perinatal center includes modern facilities for labor and delivery, neonatal intensive care and convalescent care. There is a full complement of pediatric medical and surgical subspecialities together with strongly nationally recognized programs in respiratory therapy, nursing, pharmacy, genetics, nutrition, radiology and pediatric pathology. These is a biochemistry, hematology, immunology and microbiology laboratory together with a full service blood bank. The Radiology Department is equipped with standard radiography and the latest generation of ultrasound, CT scanning, MR and PET scanners. Our follow-up program has been nationally acclaimed and boasts in excess of 90% follow-up rate for study patients. The computerized neonatal/perinatal and follow-up data systems have supported a number of studies. We have transmitted our data to the Data Center in a timely and accurate manner. Our experienced nurse coordinator and clinical research nurse team ensure high enrollment rates and compliance with protocols. There is a firm divisional, departmental and institutional commitment to participate in a collaborative manner with other centers. CWRU is proud of its record within the Network and strongly desires to continue to participate. We accept the budgetary process and have submitted an exciting concept protocol for consideration by the Network. In summary, we comfortably satisfy all the criteria for Network participation. We have the personnel, the facilities, the patient base, the data bases and, above all, the experience and commitment. We have firm institutional backing, have demonstrated remarkable productivity and the ability to collaborate, hence fulfill all Network selection criteria.